Academic literature on the topic 'Child abuse Abused children Court administration'

Child abuse has become prevalent in the society and has reached an alarming state. An experience of abuse creates a domino effect on a child’s learning and socialization in school, and consequently impacts their holistic development. Anchoring on B.F. Skinner’s Operant Conditioning Theory, this study investigates the undesirable school behaviour of abused children and formulates an intervention program for behaviour modification. This case study documented the school behaviour of three primary school children identified as psychologically, physically, and sexually abused by the local Department of Social Welfare and Development. These abused children were selected using purposive sampling. Data collection was conducted through pre, and post-observation using a validated research-made Student Behaviour Inventory, in-depth interview, triangulation, and validated Student Behaviour Intervention Program (SBIP) anchored on Cognitive Behavioural approaches. Data were analysed using recursive textual analysis using Lichtman’s framework: coding, categorizing, and conceptualizing. Results of the study revealed that abused children have opposition, refusal, and resistance to orders; sensitiveness; tendency towards social withdrawal, aloofness, and melancholy; feelings of inferiority; and non-compliance to school requirements. Administration of SBIP to abused children produced slight modification in their behaviour. This study implies a consideration of the SBIP and its administration to children who have experienced abuse as an intervention to modify their school behaviour.

This article focuses on young abusers participating in a treatment program for families where one or more children have experienced child sexual abuse and/or have abused other children. TVERS is a multiprofessional team where the treatment is performed within a frame of control ,“care and control hand in hand”. Three trained family therapists from three different agencies come together and form the therapy. The caseworker from the child care protection service (Children`s Service) becomes a part of the TVERS-team during their therapeutic work with the young abuser and his family. The therapists are given access to all reports and documents from the police, the court and medical services. The caseworker can follow up the family between appointments as well as initiate child protection procedures if necessary. The article describes our experience of working with families where the son in the family has abused other children outside or inside their own family.

A follow up to a two-year study of abuse and neglect of American Indian children looks at differences in perceptions of neglect of American Indian children found in the National Child Abuse and Neglect Data System (NCANDS). Findings from an analysis of 17,000 cases of neglect of white or American Indian children were that the neglect of American Indian children, compared to Caucasian children, was more often associated with foster care placement, juvenile court petition, alcohol abuse of child or caretaker, violence in the family, and family receipt of public assistance. The neglect of Caucasian children, when compared to American children, was more often associated with family preservation services, child or adult mental or physical problem, and inadequate housing. These data, from the 1995-1999 NCANDS, appear to confirm stereotypical assignations of neglect to American Indian families. This study supports the need for the direct participation of sovereign Indian nations in child protective investigation, treatment, and data collection, in order to create a more complete data system that will provide accurate numbers and characteristics of abused and neglected American Indian children.

This article argues that to provide adequate historical explanations for the maltreatment of children in institutional care it is necessary to ground the analysis fully in the context of the concept of child abuse and definition of childhood that existed at the time, something that many studies fail to do. Drawing primarily on the experience of the Irish industrial schools prior to the 1970s, while most commentators suggest that children were removed into care and treated cruelly because they were poor, there were also many children who entered the industrial schools who had been abused by their parents and welcomed being protected, and the community played a key role in supporting such actions. Children were treated harshly in the industrial schools not only due to their poverty but because they were victims of parental cruelty, which was perceived to have ‘contaminated’ their childhood ‘innocence’. They were treated as the moral dirt of a social order determined to prove its purity and subjected to ethnic cleansing. Prevention of such abuse today requires a radical reconstruction of the traditional status of children in care, while justice and healing for survivors necessitates full remembrance of the totality of the abuse they experienced, and that those responsible are made fully accountable.

In several recent court cases, parents of children alleged to have been abused were ordered to undergo treatment or evaluation with a therapist who required that they admit to the abuse before therapy could be concluded successfully. The parents claimed that the requirement violated Fifth Amendment rights against self-incrimination. These claims were accepted by courts, but in very limited ways. Therapists should be aware that often an admission of child abuse cannot be kept confidential. The admission may result in loss of custody, loss of parental rights or criminal prosecution. Accordingly, therapists should be aware of the liabilities that such an admission may create for a client. Courts may draw a fine legal line between effective therapy and unconstitutionally coerced admissions. To encourage full participation in court-ordered treatment, states should consider offering immunity from prosecution for admissions of past abuse made during that treatment.

The ratification of the Lanzarote Convention by Russia in 2013 entails several issues that cannot be resolved without the help of social-humanitarian sciences. Information from sociology, psychology, and jurisprudence has been used to create a concept for the empirical study of the domestic violence against children - to improve the implementation of the Convention in Russia. The concept considers two aspects of the problem - social and social-cultural. The article presents the Russian experience of how the provisions of the Council of Europe Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse are implemented. The authors analyze statistical data on the number of families in which a sexually abused child is brought up; the number of abortions and childbirths by minors; the number of minors in educational colonies; the work of the childrens helpline; the number of mediation services; the number of social service organizations for families and children; the number of professionals working with children in programs aimed at preventing and protecting children from sexual exploitation and abuse; the number of organizations providing psychological-pedagogical and medical-social assistance; the number of specialized multifunctional centers providing assistance to families and child victims of sexual abuse; the number of specialized green rooms for investigating crimes related to minors; the number of specialists accompanying minors who have come into conflict with the law at all stages of the investigation and court proceedings; the number of professionals trained under the Child Sexual Violence Protection Program and now assisting families and child victims of violence. The article will be useful for readers who study the implementation of the Lanzarote Convention and the issues of child sexual abuse and domestic violence.

Purpose The purpose of this paper is to share nascent theory, suggesting there are five types of parricide offenders. The old theories are not valid: child abuse is not the primary motivator for parricide events. Design/methodology/approach This research draws on archival data derived from public sources (i.e. court records, offender statements, newspapers, etc.). Findings Child abuse is not the primary motivator for youthful parricide events. However, it appears to remain a factor in the parricide equation. The Good Child Postulate romanticizes youthful parricide offenders and could introduce potentially harmful positive bias into investigations, trials and treatment. The nascent theory suggests the five fatal personality clusters for youthful parricide offenders. Research limitations/implications The identified clusters are still being developed and statistically validated. More research and analysis is needed to delimit, refine and verify the five fatal personality types of parricide offenders and to create a clear, cohesive theory. Practical implications Murder in general has decreased over the past decade, parricides have not. A better understanding of the phenomena may help to slow the rate of parricide events. Law enforcement, natal families and the courts can help to improve rehabilitative outcomes if children could be recognized as the type of killer they are and treated differently during the investigative and defense phases of their cases. For example, if parents are placed on trial (i.e. are used by defense to mitigate/excuse the murders), some types of children will adopt the defense arguments laid out in court and feel no need for rehabilitation at all. Families of the murdered parents can come to a better understanding of what has happened – allowing them to grieve without being forced to defend the murder of their love one. This research serves as further correction for the promulgation of the notion that all parents who are victims of youthful parricide abused the perpetrator, thereby causing their own deaths. This does occur on occasion, but is not a complete picture of the phenomenon. Social implications Although murder, in general, has decreased over the past decade, parricides have not. The standing typology stymies fresh research and researcher’s abilities to explore models that may help to teach parents, law enforcement and other caring members of society how to prevent parricides in the future. Additionally, the Good Child Postulate works to create positive bias in the courtroom as attorneys for well-off, white children can easily build an imperfect defense for a population that is not actually the abused population. This has many social justice implications. Originality/value This information can be utilized by law enforcement, attorneys, the courts, parents and the prisons/therapeutic settings to better meet the needs of the youthful parricide offender.

A parent who continuously physically abuses her/his child doesn't aim to kill the child but commits an accidental filicide in a more violent outburst of anger. Fatal abuse deaths are prevented by recognition of signs of battering in time. Out of 200 examined intra-familial filicides, 23 (12%) were caused by child battering and 13 (7%) by continuous battering. The medical and court records of the victim and the perpetrator were examined. The perpetrator was the biological mother and the victim was male in 69 per cent of the cases. The abused children were either younger than one year or from two-and-a-half to four years old. Risk factors of the victim (being unwanted, premature birth, separation from the parent caused by hospitalization or custodial care, being ill and crying a lot) and the perpetrator (personality disorder, low socioeconomic status, chaotic family conditions, domestic violence, isolation, alcohol abuse) were common. The injuries caused by previous battering were mostly soft tissue injuries in head and limbs and head traumas and the battering lasted for days or even an year. The final assault was more violent and occurred when the parent was more anxious, frustrated or left alone with the child. The perpetrating parent was diagnosed as having a personality disorder (borderline, narcissistic or dependent) and often substance dependence (31%). None of them were psychotic. Authorities and community members should pay attention to the change in child's behavior and inexplicable injuries or absence from daycare. Furthermore if the parent is immature, alcohol dependent, have a personality disorder and is unable to cope with the demands the small child entails in the parent's life, the child may be in danger.

Abuses against Children are included in Extraordinary Crimes and often occue mainly to minors. This is due to the lack of government in acting on the case. In this case, it occurred in a 3 years old boy who is abused by his own teacher. Precisely happened on April 29, 2014 at Saint Monica Sunter during the dance extracurricular activity. The victim’s mother found out about it when the victim complained of pain in the part of his penis after the victim was abused. At that moment the victim’s mother reported the incident of abuse to the authorities. It was then estabilished that the defendant was guilty of fulfilling the elements of an offense against the victim. So the defendant must be held in the prison until the court process is decided. In the indictment given by the public Prosecutor charged with using Article 82 of Law Number 23 year 2002 on Child Protection. However, the Prosecutors should be using the updated Law which is Article 82 of Law Number 35 year 2014 on the protection of new Children in the Prosecution. This proves that the Prosecutor is less careful in preparing the indictment given so as to cause legal irregularities that should in decideng the case reflects the legal objectives of Justice, certainty and expediency. Where as in legislation known as the principle of lex posteriori derogat legi priori that should be in the case of obscenity this principle is enforced. Because in the new Child protection Law more confirms the perpetrator of abuse if it is proven to commit abuse then the punishment is heavier that the old Law, and more to give special protection guarantee to the victim of abuse so that its rights will not be violated.

While research has found that millions of children in the United States are exposed to their mothers being battered, and that many are themselves abused as well, little is known about the ways in which children are used by abusers to manipulate or harm their mothers. Anecdotal evidence suggests that perpetrators use children in a variety of ways to control and harm women; however, no studies to date have empirically examined the extent of this occurring. Therefore, the current study examined the extent to which survivors of abuse experienced this, as well as the conditions under which it occurred. Interviews were conducted with 156 women who had experienced recent intimate partner violence. Each of these women had at least one child between the ages of 5 and 12. Most women (88%) reported that their assailants had used their children against them in varying ways. Multiple variables were found to be related to this occurring, including the relationship between the assailant and the children, the extent of physical and emotional abuse used by the abuser against the woman, and the assailant's court-ordered visitation status. Findings point toward the complex situational conditions by which assailants use the children of their partners or ex-partners to continue the abuse, and the need for a great deal more research in this area.

Court Appointed Special Advocates (CASAs) represent children's best interests in juvenile court proceedings. In Riverside County, conflict exists among the child advocates and children's social service workers. This study measures current attitudes and perception of social workers and CASA volunteers in a quest to gain awareness and understanding of any problems in communication that may hinder effective working relationships.

Abstract The law with special provisions on the care of young people (SFS 1990: 52) (LVU) regulates a possible way out for the social service to compulsorily act to protect children and young people who in different ways are disadvantaged. When an intervention is made in accordance with this law, high legal security requirements are set for each child in each unique case. The purpose of this essay is to analyze whether the administrative law highlights the rights of the children and the best interests of the child in a legal process regarding. This is done through an analysis of administrative law judgments. The study also includes an examination of how the administrative law chooses to take the best interest of the child into account when making a decision. The results of the study show that, in the majority of cases, administrative law emphasizes the importance of the best interests of the child coming to the forefront and the rights of the child to be fulfilled. It also emerges that the child's age and maturity are of great importance for how the administrative law views the credibility of the child's story. If the child has been able to maintain his story over time, it also appears to be something that the administrative law takes into account in the decision-making process. Whether a child is to be represented in the legal process is clear in guidelines and conventions, but how the child's story is taken into account seems ambiguous. How the children should be considered in a legal process seems obvious in theory, but through the course of the study, the reality has turned out to be different. Although the child's perspective and the best interests of the child are described as important, in some cases the administrative law is considered to have a poor child perspective.

The researcher identified in her work as a social worker that sexually abused adolescents experience difficulties with testifying in court. The goal of this research was directed at developing guidelines to assist adolescents who have to testify in court. The researcher utilised the qualitative research approach with an exploratory and descriptive nature. Semi-structured interviews were done with a sample of adolescents who have testified in court, a sample of parents or caregivers of adolescents who have testified in court and social workers working with adolescents who testify in court. These interviews were conducted to gain insight into how the research participants experienced the court process in order to formulate guidelines for adolescents who have to testify in court. The researcher concluded that adolescents experience testifying in court as negative. Guidelines were developed from the information obtained from the research participants to support adolescents who has to testify in court.
Social work
M.Diac. (Play therapy)

Good governance is the only mechanism available to provide for the basic social needs of communities within a normative and ethical paradigm. Good governance in South Africa is based on the tenets of the Batho Pele (People First) principles and practices. The primary aim of this study is to determine the factors impacting on good governance utilizing a case study of service delivery in child abuse in the eThekwini Municipal District of the KwaZulu-Natal Province. The Constitution of the Republic of South Africa, 1996, the Bill of Rights in Chapter 2, provides for the protection of all children from abuse in South Africa. There have been several policies that were developed to realize this constitutional commitment. Despite these developments, and South Africa achieving a democratic order since 1994, the abuse of children continues to occur in the eThekwini Municipal District, in large numbers as has been revealed in this research study. This research study has illustrated that the barriers to good governance in the delivery of services to children who are abused are several. They stem from structural, strategic and operational gaps that are prevalent and that have an adverse impact on the accessibility and quality of service delivery to all communities, at the coalface. The researcher is of the believe therefore that turnarounds to address these challenges of achieving good governance practices in service delivery in child abuse, will only be met from a wide range of actions involving all spheres of government at the strategic helm and the various government and nongovernmental sectors at an operational level. The processes of governance in the delivery of services in child abuse in the eThekwini Municipal District is riddled with problems and anomalies that emanate from the barrierladen structural positioning and the ineffective leadership role of provincial strategic governance structures in so far as strategic direction in this priority area of child protection, is concerned. The outcome of any service delivery program through the processes of good governance, according to current policy mandates, is that beneficiaries of services achieve sustainable development and this could only be achieved if there is a holistic services delivered to the client system. This has not happened in service delivery in child abuse in the eThekwini Municipal District. Services were fragmented and duplication occurred as the different state sectors responsible for service delivery were in the main, operating in silos. Governance in service delivery seemed to lack direction due to the absence of an intersectoral strategic planning process. There was no strategic plan to inform operations on the ground and which it is proposed, would have facilitated child protection organizations to acquire separate budgets for resource acquisition, to facilitate and support efficient, effective, economical and sustainable service delivery. In actual fact, there were no separate budgets to fund services in child abuse by the different sectors. There were therefore very limited programs available for services to child abuse victims. There was no service delivery improvement plan for child protection which is the priority area within which services in child abuse is provided for. This according to the National Policy Framework and Strategic Plan for the Prevention and Management of Child Abuse, (2004), was supposed to be the strategic core function of the Provincial Department of Social Development. There is a clear indication that this strategic governance structure has not complied with the mandate of the Public Service Regulation, 2001 by ensuring that there was a service delivery improvement plan in place for child abuse services that was well known to service providers for the period of this study. One can then from this prevailing situation conclude, that the public service policies and legislation had not been complied with in this regard at a provincial level. This had led to the lack of leadership that existed in service delivery in child abuse at the local community level. A consequence of this shortcoming was that each state department developed its own sectoral operational plans and rendered services according to these sectoral plans that were geared to meet the sectoral need which in a manner, entrenched fragmented service delivery and had resulted in victims of child abuse being exposed to secondary abuse by service providers. The present constitutional provision is that service delivery in child abuse be managed as a national and provincial responsibility under the umbrella of child care and protection services. The Public Works Department is responsible for infrastructure development for these sectors at the local level. The study has revealed that the biggest challenge to accessibility of services in rural areas was the lack of basic infrastructure of roads, electricity, telephones and safe environments, the constitutional responsibility of which is the core function of local government. The local sphere of governance does not play a role in ensuring that structural barriers to good governance in service delivery in child abuse are included in their Intergrated Development Plans (IDP), for the simple reason that it is not a constitutional functionality of this sphere of government. There is in practice, no plan in place, to address the structural barriers to improve accessibility of services in child abuse in rural areas, due to the exclusion of local government structures in this process. This arrangement is an anomalie which exacerbates the problem of poor governance in service delivery in child abuse. The attempts of decentralizing social service delivery was not achieving the purpose of taking services to the community, as the decentralized service points were still not within reach of people because of the great distances between communities and service points. Furthermore, these services only operated in the day and not after hours when it is presumed that more abuse happens, and the employed members of communities are able to assist child victims and their support systems to seek help. The study has revealed that some best practice policies such as the KwaZulu-Natal Multidisciplinary Protocol on Child Abuse and Neglect, has come into disuse in the province. The best practice model of the Thuthuzela Care Centre, was currently being piloted in two different hospitals. Communities serviced by the two hospitals running this programme, benefitted from a multi-disciplinary service provided by intersectoral roleplayers. This program is led by the National Prosecuting Authority whose aim was to improve the conviction rate of perpetrators of abuse. It has been established that funding for this programme was obtained through international donor funding. Two very significant factors emerged in this research study with regard to policy development in child abuse, and they are worth noting. The first was a reliance on international donor funding for policy development by individual government and non-governmental sectors. This has compelled policy developers then to comply with meeting the requirements of donor agencies, instead of that of the community. There was a lack of a participative governance approach through the inclusion of the local communities in these initiatives. It does appear as though policy development in child abuse service delivery was heavily influenced by global partners in governance, instead. Secondly, while good governance policies were developed such as the KwaZulu-Natal Multi-disciplinary Protocol on Child Abuse and Neglect, its implementation was not supported nor monitored by the responsible strategic governance structure and this resulted in such policies being ineffective. The policy review process as well was not fully participative and did not promote local community input. While politicians have focused on policy development in response to an externally identified need other than that of the affected community, there has been no provision for the required resources and strategic leadership for ensuring coordinated holistic accessible service delivery. Neither has there been provision for oversight and support services to ensure that implementation happens at a community level. While the Department of Social Development is mandated to be the lead department in matters of child abuse, it seems not to have strongly positioned itself in this regard. This department assumed a weak position in so far as taking on responsibility for leading and directing services to children who are abused. There are too many different policies that are developed by the national department and handed to the province for implementation in local communities. Some of these policies address a similar aspect of service except that it comes from a different sector. This has caused a great deal of confusion on the ground as to which was the relevant policy to implement. There appears to be a rigorous attempt at policy formulation and development with very little regard to the support resources such as additional staff, equipment and the required intensity of training for key personnel. It has led to frustrations felt by intersectoral service providers at grassroots. Child abuse is a phenomenon of living and that requires crisis intervention by significant role-players at a grassroots level when it occurs. The study has revealed that important sectors who impact on the daily lives of people have been excluded from the governance processes. These structures are local government, the house of traditional affairs, business, cultural and religious organizations and the local community. The researcher proposes the utilization of the Governance Model in public administration which should be primarily community based and include all local governance structures. It therefore supports the bottom-up intersectoral approach in its modis operandi. Furthermore, service delivery should be provided from a one-stop centre under the leadership of a project manager. The model embraces ethical and normative theoretical practices within a democratic and developmental paradigm. This model repositions the strategic planning responsibility to local governance structures and proposes that the provincial structures assume a monitoring and oversight role which should be participative and which should include community representation.
Thesis (Ph.D.)-University of KwaZulu-Natal, Westville, 2010.

Childhood abuse, whether physical or sexual, is a major public health issue. The most recent United States data from Child Protective Services (CPS) show that in 2013 there were 3.5 million referrals of child maltreatment involving 6.4 million children. Out of these cases, 18% were for physical abuse and 9% were for sexual abuse. However, researchers argue that CPS data grossly underestimate the prevalence of childhood abuse as most childhood abuse goes unreported. Indeed, to date, the true prevalence of childhood abuse remains unknown as research has been hampered by inconsistent definitions of abuse and wide variation in methodologies including measures for its identification and modes of administration of these measures. Although a health care visit presents an opportunity to identify a childhood abuse history, health care providers frequently fail to ask about it. The reasons doctors give for not asking about abuse include lack of training, not knowing how to ask, and lack of familiarity with practical methods for screening that can be used in primary care settings. There is little to no research on effective means for identifying childhood abuse histories, especially in the adolescent and young adult population, or on how different modes of administration of screens to identify childhood abuse compare to each other. The net result is that most childhood physical and sexual abuse is never identified and many victims do not get the needed services to help them heal. When unaddressed, childhood abuse has negative impacts on victims’ health and wellbeing over the life course. Prior studies of adults show that when compared with non-victims of abuse, victims tend to perceive their health as poorer and utilize more health care services including emergency room and urgent outpatient care. These studies also suggest that adult victims use less routine and preventive care than non-victims. Only two studies, conducted among widely different adolescent populations, have examined how adolescent victims perceive their health. Similarly, limited evidence examining perception of health is available for young adults. These studies found that victims perceive their health as poorer than non-victims. There have been no adolescent-specific studies of how victimization impacts adolescents’ utilization of health care. One study includes participants ages 15 to 98 years and only two studies focusing on this issue in samples primarily of young adults attending college have been published. These studies found that victims utilize more health care than non-victims. Therefore, we lack a sufficient body of evidence to come to clear conclusions of how childhood abuse affects self-perceived health in adolescents and young adults. The general lack of evidence about both how childhood abuse impacts perception of health and utilization of health care in adolescents and young adults indicates a need for further study. Given that little is known about how to best identify an abuse history in adolescents and young adults and the impact of abuse on perception of health and utilization of health care, this dissertation pursued three aims: (1) to review the literature comparing modes of administration of screens to identify adolescent and young adult victims of childhood physical and sexual abuse; (2) to investigate how different modes of administration of screens to identify adolescent and young adult victims of childhood physical abuse within a primary care health setting compare to each other, and; (3) to examine the association of a history of childhood abuse (defined as none, physical only, and sexual with or without physical) with perceived health status and the health care utilization patterns among adolescents and young adults. For aim 1, a comprehensive literature review was conducted via PubMed of studies, published between January 1st, 1994 and December 31st, 2014 that compared modes of administration of screens to identify a history of childhood physical and sexual abuse in adolescents and young adults. Only one study was found. This study compared paper and pencil questionnaire, computer assisted survey, and face to face structured interview in the identification of childhood physical and sexual abuse among young adults in a college setting. No significant difference in the proportion of childhood physical abuse or childhood sexual abuse was identified by mode of administration. The identification through this search of only one study – which was conducted among college students, with no studies done among adolescents – shows a significant gap in our knowledge regarding this issue. Given that understanding how to identify childhood abuse is a critical issue, this gap is disturbing and underscores the need for studies of identification of childhood abuse to be a research priority. For aim 2, a sample of participants, ages 12-24 years, receiving health services at the Mount Sinai Adolescent Health Center in New York City were randomized to one of four modes of administration to identify a history of childhood physical abuse. The four modes of administration of screens to identify childhood abuse were paper and pencil screen, Audio Computer Assisted Self Interview screen (ACASI), face to face structured screen and face to face unstructured interview. The full sample also completed measures to assess demographic characteristics and to screen for depression symptoms. Of the sample, 44.5% of the participants disclosed childhood physical abuse. There was a statistically significant difference in the proportion of childhood physical abuse identified according to mode of administration: face to face unstructured interview identified the highest proportion of childhood physical abuse victims, followed by face to face structured screen. After adjusting for age, gender, race/ethnicity, depression, living arrangement and last grade completed, the odds of identifying physical abuse was 1.6 (95%CI: 1.0, 2.7) and 4.5 (95%CI: 2.6, 7.8) greater for face to face structured screen and for face to face unstructured interview, respectively as compared to paper and pencil screen. ACASI and paper and pencil were similar to each other but inferior to the face to face methods. For aim 3, in addition to what was measured for aim 2, the sample completed measures on a history of childhood sexual abuse and perceived health and health care utilization. The sample was then categorized into three groups: no abuse, physical abuse only, and sexual abuse with or without physical abuse. The association of childhood abuse status with perceived health and health care utilization were examined. There was no statistical significant association between a history of childhood abuse status and perceived health. However, the odds of reporting a fair/poor perception of health among those reporting childhood abuse were at least 40% lower regardless of whether the abuse was physical (OR: 0.60; 95%CI: 0.3,1.2) or sexual (OR: 0.50; 95%CI: 0.2,1.1). No significant association was found between childhood abuse status and health care utilization. However, the odds of victims reporting using urgent care only versus routine care only were at least 10% lower regardless of whether the abuse was physical (OR: 0.50; 95%CI: 0.3, 1.1) or sexual (OR: 0.90; 95%CI: 0.4,1.9). The odds of reporting using both urgent and routine care versus routine care only was similar between victims and non-victims for physical abuse (OR: 1.0; 95%CI: 0.6, 1.5) and was 30% higher for victims of sexual abuse (OR: 1.3; 95%CI: 0.8, 2.2). The findings from the three aims examined identified significant gaps in our knowledge on childhood abuse among adolescents and young adults suggesting an urgent need for further research. While much research has focused on the impact of childhood abuse on health and well-being, aim 1 reveals that little is known about which mode of administration of screens to identify childhood abuse is most effective in the identification of childhood abuse in adolescent and young adults. Furthermore, we know even less about what modes of administration of screens might be practical in primary care settings, or what must be done to improve the level of screening for childhood abuse by physicians and other health care providers. Although the findings from aim 2 suggest that face to face modes of administration are most effective in screening for childhood physical abuse in primary care settings, further studies are needed to support these findings. In addition, there is a need for studies that examine what are the best methods to use to identify childhood sexual abuse in primary care settings. The findings from aim 3 suggest that adolescents and young adults with a history of childhood physical and sexual abuse, receiving health care at the Mount Sinai Adolescent Health Center, do not perceive their health as worse than non-victims nor do they appear to utilize health care differently from non-victims. These findings contrast with results from prior studies of perceived health status and health care utilization among adolescents and young adult childhood abuse victims. Understanding how abuse impacts both the perception of health and health care utilization will be crucial in the development of interventions to identify and support adolescent and young adult victims of childhood physical and sexual abuse.

Gestalt play therapy court assessment
Child victim
Sexual crime
Legal professionals
Assessment guideline
Intermediary
Text in Afrikaans
As a source of information the court needs to be convinced of the witness's credibility and the ability to recall and communicate the truth regarding the Incident. Mostly the court uses the expertise of an expert witness to assist it in making a decision regarding the way in which a child needs to testify in court. Experts in this field are challenged to align the legal requirements with those of their field of expertise. In this research the Gestalt therapeutic approach is used to design an assessment guideline to assist experts to assess the ability of child victims of sexual crimes to testify in court. The Gestalt therapeutic approach focuses on the present (here and now) and has the ability to obtain access to the information present in the child's life. In the proposed assessment guideline certain Gestalt play therapy methods are recommended to assist the expert to assessing the child victim of a sexual crime.
Play therapy
M.Diac. (Play therapy)

Summary in Afrikaans and English
Although the rights of children in South Africa are being regulated by legislation, statistics prove that statutory services on behalf of children annually increase. Scientific accountable information regarding the child can be obtained by the assessment of the child. The purpose of this investigation was to identify the gaps in the existing assessment guidelines, as well as the needs of social workers regarding assessments. The sequential exploratory strategy was utilized, as quantitative data supported qualitative findings. The investigation showed that minimal assessment literature is available in South Africa and internationally, although assessment is the basis evidence of the social worker. The biggest gap in assessment guidelines is that assessment does not carry weight in the court. There is a need for social workers to be trained in relevant assessment skills based on a specific frame of reference. Gestalt therapy can provide a suitable theoretical frame of reference for assessment, and can serve as scientific foundation for social workers during the statutory process. A framework for an assessment guideline was thus proposed.
Ten spyte daarvan dat die regte van kinders in Suid-Afrika deur wette gereguleer word, bewys statistiek dat statutere dienste aan kinders jaarliks toeneem. Wetenskaplik verantwoordbare inligting ten opsigte van die kind kan bekom word deur die kind te assesseer. Die doel van hierdie ondersoek was om leemtes wat in bestaande assesseringsriglyne is vas te stel, asook die behoeftes wat by maatskaplike werkers ten opsigte van assessering bestaan. Die opeenvolgende verkennende strategie is tydens hierdie ondersoek gevolg, aangesien kwantitatiewe data gebruik is om die kwalitatiewe bevindings te ondersteun. Die ondersoek het getoon dat min literatuur ten opsigte van assessering in Suid-Afrika en internasionaal beskikbaar is, ten spyte daarvan dat assessering die basis van die getuienis van die maatskaplike werker vorm. Die grootste leemte wat in assesseringsriglyne ge'identifiseer is, is die feit dat assessering nie gewig in die hof dra nie. 'n Behoefte ten opsigte van opleiding in toepaslike assesseringsvaardighede vanuit 'n spesifieke teoretiese verwysingsraamwerk bestaan. Gestaltterapie kan 'n teoretiese verwysingsraamwerk vir assessering bied en kan dien as wetenskaplike fundering vir optrede van maatskaplike werkers tydens die statutere proses. 'n Raamwerk vir 'n assesseringsriglyn is voorgestel.
Social Work
M. Diac. (Play Therapy)